12-lead electrocardiograms (ECGs) in ambulance services: diagnosis of suspected ST elevation myocardial infarction (STEMI) — HSSIB

Summary response We welcome the opportunity to respond to the safety recommendation outlined in this report and fully support the intention to strengthen decision making around the procurement of monitors and defibrillators across ambulance services. At NHS Supply Chain, in order to enhance the knowledge of technical capabilities of devices available through the framework, and to support informed clinical and procurement decision-making, NHS Supply Chain are in the process of updating our Statement of Requirements (SOR) document. The SOR is a formal document provided to NHS trusts at the initial stage of engagement when procuring medical devices. It sets out the essential functional, technical, and clinical requirements that suppliers must meet. By refining this document, we aim to give trusts clearer, more comprehensive information, enabling them to compare device options more effectively and make well-informed purchasing decisions. In addition, to improve longer term clarity and ensure the framework better reflects how these products are used in practice, we have proposed a revised lot structure for the future framework. This will group products into more coherent, clinically meaningful categories, improving transparency and supporting more informed decision making. These changes, along with updates to device specifications aligned to the findings of the investigation will be embedded into our new framework, scheduled for launch in August 2027. NHS Supply Chain remains committed to strengthening procurement processes to support patient safety, clinical effectiveness and the needs of frontline services. Actions planned to deliver safety recommendation: Update our Statement of Requirements documents with additional features to support trusts with clearer, more comprehensive information, enabling them to compare device options more effectively and make well-informed purchasing decisions, by March 2026. NHS Supply Chain will introduce a new lotting structure and make the recommended changes to our specifications for our future Framework, by August 2027. Response received on 2 February 2026.

Summary response: The published PPCI service specification (A09/S/d - https://www.england.nhs.uk/wp-content/uploads/2018/08/Cardiology-primary-percutaneous-cortonary-intervention-adult.pdf is due to be reviewed by the cardiac services clinical reference group (subject to resources) within the next 18-24 months. Communication between the ambulance service and the heart attack centres is already included as a requirement within the existing service specification, however, we agree that the requirement should be updated in line with HSSIB's recommendation. It is important however that there is onus on both the ambulance services and PPCI centres so that paramedic crews have the appropriate equipment and training to enable 2-way communication. NHS England will send a communication to regional commissioning teams and commissioned providers to remind them of the existing requirements within the published PPCI specification with regards to 2-way communications with ambulance services. NHSE accepts this recommendation and will include as part of the revision of the service specification. Actions planned to deliver safety recommendation: NHS England will send a communication to regional commissioning teams and commissioned providers to remind them of the existing requirements within the published PPCI specification with regards to 2 way communications with ambulance services, by 29 January 2026. Revise the published PPCI service specification in line with NHS England’s national methods process: https://www.england.nhs.uk/wp-content/uploads/2018/08/Cardiology-primary-percutaneous-cortonary-intervention-adult.pdf , by March 2028. Additional information: To be included within 26/27 cardiac services clinical reference group workplan (subject to resources). Response received on 2 February 2026.